Ear Hematoma

An ear hematoma is a pocket of blood that forms inside the exterior portion of the ear.

Often, ear mites or an infection in the ear canal cause a pet to scratch or shake his or her head. If aggressive scratching or head shaking causes the blood vessels inside the ear to break, a hematoma can form.

Diagnosis of the ear hematoma is made by physical exam; diagnosis of the underlying condition requires examination of the ear canal and a swab of the ear contents.

Surgical correction is usually the most effective way to prevent recurrence and preserve the natural appearance of the ear.

Treatment of any underlying condition is necessary to prevent further problems.

What Is an Ear Hematoma?

An ear hematoma is a pocket of blood that forms within the exterior portion of a pet’s ear. Although both dogs and cats can have ear hematomas, the condition is more common in dogs.

What Causes an Ear Hematoma?

Ear hematomas are usually caused by some kind of self-trauma—such as when a pet aggressively scratches at the ears or shakes his or her head, causing the ears to slap against the skull. This trauma can cause blood to leave the blood vessels and pool in a pocket between the skin flaps that make up the outer part of the ear.

Usually, there is an underlying cause for the scratching and head shaking, such as ear mites or bacterial and/or fungal infections of the ear canal. It is crucial to treat both the ear hematoma and the underlying parasites or infection.

What Are the Signs of an Ear Hematoma?

A pet with an ear hematoma will have a fluid-filled swelling on all or portions of the inner surface of the ear flap.

How Is an Ear Hematoma Diagnosed?

Your veterinarian can diagnose this condition with a physical exam. However, it is also important to diagnose underlying conditions that may lead to excessive scratching or head shaking. The veterinarian will most likely inspect the ear canal and swab it for a sample to examine under the microscope for signs of parasites or infection.

How Is an Ear Hematoma Treated?

Surgical repair is usually the most effective treatment for ear hematomas. While your pet is under anesthesia, your veterinarian will make an incision along the length of the hematoma on the inner surface of the ear. After the fluid and blood clots are removed, the inner surface of the ear is tacked down to the outer surface of the ear with sutures. The sutures hold the inner and outer surfaces against each other so that when scar tissue forms, the two surfaces are smooth and not lumpy. The sutures generally stay in place for a few weeks. The incision is left open so that fluid will continue to drain as the ear heals. Eventually, the incision will heal on its own.

For dogs with droopy ears, the treated ear is often flipped up and bandaged against the head to prevent head shaking during recovery. An Elizabethan collar (a cone-shaped hood that fits over the pet’s head) is often recommended so pets can’t scratch at the ears.

As an alternative, several small incisions may be made on the inside surface of the ear with a laser. In this case, sutures are not needed.

Another treatment involves the placement of a small drain, or rubber tube, in the external portion of the ear. The drain is kept in place for several weeks as the fluid resolves and the ear heals. Some pets may not tolerate this, and cats’ ears are usually too small for this technique.

In some cases, veterinarians may draw out the fluid with a needle and syringe. Medication may also be injected into the space to reduce swelling and inflammation. However, it is very common for the hematoma to come back with this procedure.

If there is an underlying ear infection or ear mites, your pet will most likely need to have the ear canals cleaned and treated with ointment or drops. Resolution of the underlying problem will help prevent another ear hematoma.

Without treatment, the ear hematoma will eventually heal on its own, but your pet will probably experience weeks of discomfort. In addition, the two sides of the ear often form thickened, wrinkled scar tissue, so the ear won’t look or feel natural. If the underlying ear condition is not treated, your pet will continue to scratch or shake his or her head, and there’s the chance that the other ear may develop a hematoma.